Active NPI
Deepak Raj
- Internal Medicine Physician
- Gulfport, MS
National Provider Identifier
1174227714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- T-5157
- Practice address
- 4500 13TH St
Gulfport, MS 39501-2515 - Phone
- (228) 822-6512
- NPI assigned
- Mar 28, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | T-5157 | MS | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
4500 13TH St
Gulfport, MS 39501-2515
Mailing address
4500 13TH St
Gulfport, MS 39501-2515
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230914002106 | MS | Order and Referring Only - Internal Medicine | 1759745391 |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
200 Corporate Blvd
Lafayettte, LA 39502
200 Corporate Blvd
Lafayette, LA 70508-3844
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T-5157 | MS | MD | Internal Medicine Physician |
Interoperability endpoints
- draj@direct.mhg.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779753600000",
"number": "1174227714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 13TH ST",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395012515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 13TH ST",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395012515",
"telephone_number": "228-822-6512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAJ",
"first_name": "DEEPAK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-28",
"last_updated": "2026-05-26",
"certification_date": "2026-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MS",
"license": "T-5157",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gulfport, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.